This whole thing makes me so angry, especially when the docs focus on hot flashes and night sweats. Yes, those are no fun, but my symptoms were much, much worse. I felt like I was falling apart mentally, physically and emotionally. I had almost all of the symptoms mentioned in the godsend of a book, Estrogen Matters. I would’ve given up 10 years of my life to feel better and be functional. I would’ve had a prophylactic mastectomy if that’s what it took. No doctor would prescribe estrogen for me because I had a stage 1 breast cancer in 2015. I’ve been cancer free since then and I understand the supposed increased risk in a recurrence (which I don’t necessarily buy.) In any case, it should be my choice - it’s my body and my life. I was lucky to find a friend who was willing to prescribe estradiol patches for me. My quality of life increased 10-fold in about a week. They can pry my estradiol patches out of my cold dead hands. I intend to stay on estrogen for the rest of my life. I believe that starting early will help prevent the conditions that are more prevalent in older age. I agree that it is sad that millions of women suffered unnecessarily since 2002. What about the millions of breast cancer survivors that are currently suffering? Dr Avrum Bluming has an article that goes over every study regarding estrogen after breast cancer and I am convinced that the current “contraindication” will someday be shown to be wrong. Even if there is an increased risk of recurrence, I am willingly taking that risk. Who wants to feel like hell for 25-35+ years of their life? Not me.
amen sister. Slightly increased health risk, somehow that is more important than the fact that I was 100% miserable and barely able to function. Everything has risk. Viagara has risk but men are allowed to weigh their own risks and make their own choices when it comes to that. we women are supposed to suck it up,”it’s normal honey” when it comes to feeling like hell in menopause. I finally got my estrogen patch and within 2 days I was back to normal. alcohol and processed foods and cured meats are far more dangerous than the damn estrogen, but no doc every tells you that. Whatever X% health risk I get from HRT, I got back several times over by eating a whole food plant based diet.
For those who were denied estrogen for hot flashes did you try the other meds like the SSRIs, Clonidine etc? I found that my hot flashes are made worse by electrolyte imbalance/dehydration.
Started HRT at 58. DEXA scan prior to HRT showed osteoporosis and osteopenia. After a year on HRT osteoporosis now osteopenia and areas of osteopenia now normal bone. This along with other benefits of HRT have been amazing.
That is so encouraging! Did you do anything else like take calcium or weight bearing exercise? I’ve heard those measures don’t do much if you have no estrogen. I would love to have those results. I had a similar improvement when I was on it but then I had to get off after breast cancer. I’ve just restarted!
@@rosiet253 Progestin the patented synthetic form of progesterone can cause breast cancer yet this garbage is still prescribed rather than natural progesterone
Yes on the weight bearing exercise and I’ve been taking AlgaeCal Plus at the recommendation of my MD. You have to buy it from the company. On the expensive side unfortunately.
I tried it twice, but it caused brain fog and some bloating, which is opposite of what many women report -- so I stopped it. I obviously don’t have to take it, as my uterus was removed.
@@04Serena What kind of HRT? I had a hysterectomy about 8 years ago at 55. I first went on an estradiol gel, but switched to the oral because the gel was so expensive and my insurance paid very little of the cost. the oral is so inexpensive that even without insurance it is affordable, I need to look into the bio identical type. I don't even know what makes the biodentical different or how expensive it may be. I too intend to be on HRT until I die from what ever cause. Quality of life is more important to me than the length of my life. With this said, my bone scan a few moths ago did show that I had osteopenia, so hoping i can turn that around with supplements and weight bearing exercise, I.E. walking and some light weight lifting (due to my muscles seeming to going away).
I'm a doctor and although I'm not in the same specialty, I'm very interested in the topics you discuss. The topic of HRT is extremely important in my opinion for women's health. I would like to kindly ask you to consider hosting a future podcast with an expert in the field and delve into the science and the benefits and risks of HRT as made evident by the latest research. I find your podcasts of great educational value not only to the general health conscious public but also to clinicians concerned with the well-being, longevity and reduction of all-cause mortality of their patients. I really value and appreciate your educational and research work, thank you very much and I look forward to listening to the podcast on this topic in the future.
@ronaldharrison7742 only if you have your reproductive organs , I was given it after hysterectomy and had such swollen sore breasts. Premarin works for me .
@@jenn1fermeyer468 Premarin, meaning from horses urine may well help you but I am talking about money making Progestin being used as a replacement for natural progesterone..
60 this year .. started HRT last fall.. Tremendous benefits including being able to orgasm again after not being able to at all for several years due to an antidepressant. The affects overall have been so good I'm now weening off the antidepressant! It's good to feel alive again!!
@@cynthiahansen2341 I have pellets in my hip of estrogen and testosterone. Oral progesterone..100mg.... Originally doc prescribed me 200 but I've never smoked or drank or done drugs so I'm an extreme lightweight in that department. It was knocking me out... I've since tweaked it to the 100 mg and I take it about 6 p.m. so I'm nice and drowsy come 9 -930 which is great for me. This way it's completely worn off by morning and I have my energy back. If I forget to take it early I just don't take it at all because it does keep me kind of sluggish in the morning if I take it late. But again I'm a real lightweight!! I had pretty good sleep hygiene before I started on the progesterone but this it's been the icing on the cake! I sleep with the house on 62 and the ceiling fan going. I sleep like a baby now... Even on the nights I miss taking it. I also don't eat after 5 in the evening which helps with my sleep. I also consume zero sugar and keep my carbs very low. I have zero aches and pains between the diet and the HRT.... 20lbs fell off of me. I haven't felt this good in a couple of decades, mentally emotionally and physically. If you have any questions about the sexual health benefits of it just ask I'm an open book. Not sure where you're at but I'm in the Waco TX area if you need a recommendation fo r a doctor. I love him and his staff!!
@@theflamboyantgrandma1890 thx so so much! I am in utah...and a widow..so not too worried about that aspect..but more concerned about brain health an memory. I have done all those food things. Take quality supplements an nootropics. Now started experimenting with herbs for memory etc. (Personal lost 21 daughter last summer so hard to place exact cause of no motivation) want to up my testosterone for brain an drive?
THANK YOU DR. ATTIA for posting this important topic. HRT saved my life. I started getting panic attacks and memory loss and depression. HRT resolved all of my issues!!!
Dear Dr Attia, I would like to propose a (perhaps) new angle in approaching the topic of HRT in peri- and post-menopause. I would love it if you had a guest who can take us into estradiol’s role in ALL the organ systems of a woman’s body where this hormone has functions, and preferably into a level that goes beyond “estradiol is good for the bones, heart and brain”. I have heard that there are estrogen receptors in every organ system of a woman’s body, meaning estradiol serves many purposes beyond the reproductive functions … I would really like a more detailed lecture on what estrogen does on a cellular level to keep a woman’s body functioning optimally. I would like to learn, what happens to those bodily functions when estrogen is no longer produced by a woman’s ovaries. Once we understand all the important roles of estradiol (and progesterone, and testosterone) in the female body, we can ask why we are not viewing and treating it as a hormone deficiency like any other (thyroid hormone, insulin, vitamin D)? Dr Louise Newson in the UK, for instance, works tirelessly in this area, to have us understand menopause as a “long term female hormone deficiency with health risks”. Ideally, it should be a woman’s choice whether to take hormone therapy for her quality of life and to help prevent important diseases.
Well said. While we’re at it, let’s understand exactly what natural levels of progesterone and testosterone do at a celular level throughout a woman’s body…if science has even explored this question.
Quite right, have you ever wondered why Doctors seem loathe to have ALL your hormones tested? They likely know that correcting them will cure a multitude of your issues with them being unable to prescribe profitable but harmful drugs.
@@marinasolt6232 We already know this. The natural levels in your early twenties are your optimum levels, it does not take rocket science to determine an average using a large enough number of people and so calculate a beginning dosage for you to return you to those levels.
I had a hysterectomy/oophorectomy at age 23 and was profoundly symptomatic afterwards. I was initially prescribed Premarin, but after learning about liver cancer risks, transitioned to transdermal. I’ve been on ERT for 50 years, and at the age of 70 , had a hard fall from a road bike directly onto my hip, hitting so hard my hip turned black -- but no bone damage... I have great bone density. Symptoms controlled by a little patch include migraine, PVCs, insomnia, soaking sweats, labile moods, formication, and insatiable appetite. Symptoms improved but not fully relieved are dry eyes and mouth, memory issues, and anxiety. I’ll be on ERT till I die, even if that comes earlier than it might otherwise.
I was not a fan of this guest. She was a tad defensive about the WHI and still projected fear about HRT. She brought up antidepressants as an effective alternative?? I guess if you’re clinically depressed, but why else would someone take a drug that alters brain chemistry and promotes weight gain. I think there are better experts out there: Susan Davis, Heather Hirsch, Barbara Taylor, to name a few. But Peter Attia is doing a wonderful job of highlighting overlooked women’s health issues.
From the hours I’ve spent reading studies If a woman takes estrogen only her breast cancer risk goes down. But her risk of uterine cancer goes up If she takes both estrogen and progesterone her risk of uterine cancer goes down and breast cancer has a slight increase But estrogen and progesterone also lowers risk of osteoporosis , heart disease and newer studies show also decreased risk of dementia. Not to mention overall happiness about life and being able to sleep. Seems the benefits outweighs the risk
Great topic!! Though I'm 68, in that group that "was denied" HRT, still suffering greatly and would like to start HRT, which I likely will, but would LOVE for you to discuss older women starting HRT. Quality of life is EVERYthing--for me anyway. ;-)
I started back on HRT at the age of 68 after 20 yrs of misery and increasing health problems. I have reversed my hypertension, my cholesterol is back to normal, I’m sleeping well, I’ve lost weight, and reversed my osteoporosis. Just to mention a few things. Brain fog is much improved. Anxiety levels are way down…. And on and on.
Chiming in from Canada 🇨🇦 Can’t thank you enough for providing this unbelievably critical information. Just started HRT. Estrogen & progesterone. I’m already feeling a million times better! And finally sleeping. Thank you so very much 🙏🏻
Thank you Dr. Attia for your support of Women’s Health! It is so sad to me as a Registered Nurse that women are being denied by the medical community of a treatment that can and will improve the quality of their life. I’m 52 and have been denied HRT by 2 providers so far. I am saddened and shocked at the ignorance and lack of knowledge that most medical providers have on HRT. Thank you Dr. Attia for raising awareness! God bless.
This episode illustrates the power of persuasion and being a good orator. I have listened and re-listened to this podcast and if I were to exclude Dr. Attia’s commentary, I would believe that HRT is still dangerous and the only benefit is to reduce lost sleep and hot flashes due to menopause?!? Perhaps it’s her monotonous tone or fear of implicating herself by stressing the positives, though honestly this detracted from me looking into HRT unless absolutely necessary. I think you need a guest that stresses the positives backed by clinical data. If the intention was to get people to re-examine the controversial women’s health initiative and not fear HRT, it missed the mark. Please have a guest on that can speak honestly to the positives backed by clinical data to support HRT. Her responses were like a politician answering questions…though in the end left the female listener still weary.
Ditto, I also would love to see a podcast with someone who doesn't have a horse in the race. It seemed the focus was on breast cancer, would like more info on heart health, stroke, cognitive issues.
I thought the same thing. I thought it was ridiculous when she said a particular result “almost reached statistical significance.” So it wasn’t statistically significant. Sheesh!
I started menopause at 52. I am 59 now and just talked to my doctor last week about my hormones for sleep and bone health . This podcast was very interesting and I would love to learn more. Thanks for the timing of such an important topic.
I did listen and re-listen and again and Im actually horrified . Obviously amount of publications is not a best measure of quality of someones work . The lady and her team did properly messed up that studies over 20 years ago and she is still protecting it ! I mean , she is an endocrinologist and she prefers to put women on gaba antidepressants then HRT? Night sweats are only inconvenience? My mum was taken of HRT straight after thus studies . Strait after she put on 20 kg, she get osteoporosis and lost 80 % of hearing. Now she has vascular dementia …. Thank you Peter for introducing to me the woman who is partly responsible for my mums and my family suffering.
Shes a talking head for the "hellthcare"system and she doesnt even know it, because shes dedicated her life to being "right" about this study. She's full of a whole lot of "buts" Imagine being her patient, and she gaslights you into antidepressants (which are hormone therapy) instead of the proper hormone therapy needed. Makes my skin crawl.
I was taken off my HRT at the age of 50. In 2003. I’ve got osteoporosis with two fractured vertebrae. And dozens of other menopausal symptoms. Weight gain, awful anxiety and brain fog. Swollen feet so painful I couldn’t walk for more than 15-20 mins. Loads of other stuff. Horrible. I really felt I was physically falling apart. Not to mention the mental stuff. Not sleeping. And on and on. I went back on HRT after 20 yrs. Within 2 weeks my swollen painful feet went back to normal. My osteoporosis is reversing. I’m now osteopaenic. My anxiety is hugely reduced. I’m sleeping like a baby. So many other benefits including weight loss (yes I’m eating much better). My BP is now normal. My cholesterol is normal. I attribute all that to a proper eating plan as well as HRT. If anyone suggests o come off the HRT I’ll go through them for a short cut! 😊
I'm almost 50, and I'm on HRT for about 8 months. I am a very cautious"natural organic" person , and after taking natural suplements to ease my " pain," I knew that I would take HRT, just for my own and my close ones sake. I'm lucky that my doctor specializes in this field, and after some tests for blood clothing and stroke, I was on it and can not be happier. I think I did escaped that "Karen" stigma just on time. You do you, but when a nice person becomes a monster and you don't know why, then maybe you should consider that possibility. Big thanks to Dr. P. Attia for his content, especially on peri/menopause issue, and for the book as well.
100% I couldn't agree with you more! I am 51 (almost 52) and I got lucky to work with a Reproductive Endocrinologist who keeps up on the most current information regarding cancer risk with HRT. I use Bioidentical Hormone Replacement Therapy.
Same! I’m turning 50 soon and it’s just now dawning on me that the series of mystery symptoms I’ve had for 2.5 years now is hormone imbalance. It took several people over this period of time suggesting I get my hormones checked to believe it! Because I have normal periods. But 6 months ago the mild hot flashes started and now my immune system is in the toilet. Still, period completely normal. Doing my research now and probably going to take the plunge asap. Glad you’re feeling better!
Hello there, from Romania! I really hope that by the end of listening to this podcast, I can make a more informed decision about HRT when it will be the case! Many many thanks to Peter and JoAnn❤🙏
Hi also from Romania 😊. I have not found a doctor that understand my issues. I have some relatives with breast cancer but also with type 2 diabetes. I entered perimenopause around the age 38 and since then I use the combined pill. Never used it before. I saw what a struggle diabetes is and I want to minimize it. I will look in other methods of HRT.
Peter is an exemplar of diplomacy with someone who--although as Peter acknowledges, has been one of few WHI investigators to openly speak out regarding the study's limitations--did not bite on Peter's opportunities to acknowledge the "limitations" of the WHI on a broader scale, but rather, fed listeners the same spiels repeatedly.
I’m post menopausal (56yo). I was told when I went into menopause that HRT was “risky and bad “. Therefore, I chose not to take HRT. Can I go on HRT at this stage? Now I have Osteoporosis treated with Fosomax and Calcium (k-d3-magnesium) for 5 years but unfortunately it’s not improving. Now they’re telling me I need to go on Prolia. No thanks! They can’t even tell me how long I can safely stay on Fosomax! I’m extremely healthy, great weight, no other illness, 3-4x per week weight bearing exercises and I eat very clean (ok, maybe ice cream and chocolate sometimes😂). I went hiking recently with my husband and was terrified the whole time I was going to fall and break a hip. All I hear from my doctors is “it’s time to slow down.”…WTH?!? I’m in the prime of my life.
get a new Doctor. Watch the videos of the Doctors: Louise Newsom, Felice Gersh, and Marie Claire Haver. They have and do read and understand all studies and the bio and chem. We deserve better than docs who think they are the deciders with inadequate knowledge. It was docs who got us 70yrolds into this hormone DEFICIENCY state. i'll be d**mned if ill let them keep me there without good cause
I agree with the mental clarity comment! I had a total hysterectomy including ovary removal and HRT has given me such clarity of mind. My life is 100% better because of mental clarity. I’m 46.
I am a NAMS NCMP & saw Dr Mason speak at ASRM 2022. She continues to say we will never have a chance at another HRT RTC, but refuses to use any of the high quality ocservational data we DO have on E2+OMP. Please bring Drs Buming & Tavris back for an update!
I’m tired of hearing her say “we don’t know”!! I’m 61 and I’ve been struggling with menopause for years……. I was on Estradiol with my previous pcp BUT the last couple years my FNCP or whatever her acronym is took me off of it because my Mom had breast cancer in 2020. Thank God she’s completely cancer free🙏🙏🙏🙏 But I feel personally I should be given the opportunity to get back on the Estradiol considering I AM THE ONE STRUGGLING!!
Manson is infuriating. Her arguments that women shouldn't be on HT to protect us from debilitating fractures because of the PURPORTED long-term risk of breast cancer is such a false equivalency and does a disservice to millions of women. She has set us all back because she is so convinced of her opinion that women in their fifties seldom have fractures. 58:20 What about joint instabilities and massive pain that prevent us from performing bone-strengthening exercises that PREVENT THE FRACTURES IN THE FIRST PLACE?? We need the estrogen for that!! I was lifting weights successfully for years and getting stronger on ET. I couldn't see my provider for 5 weeks, and my knees developed severe pain. I couldn't even walk. FIVE WEEKS. that was all it took to deplete my estrogen
To be honest the night sweats were crushing for me and my obgyn told me to simply deal with it. The lack of sleep has been crushing. The denial of therapy despite years long suffering is a disaster for women.
Oh Dr.Attia so happy that you take stance that you do on hormone replacement therapy. I’ve been very lucky never had a hot flash I’m 77.5 actually 77.6 and I took it early on Waltz through it. I did not change life to very late in the 50s And I believe it’s good but I believe they were all some of us are scared of the word cancer, so this is a good show for me. No wt problem ever love exercise and played tennis since I could hold a racquet. Diet only eat small amount of grass fed organic beef or chicken; much sea food; don’t drink at all; low glycemic carbs; no soda 40 or 50 years. Understand sugar but wow love Costco’s desserts: But try to use it as a sacrament upon occasion only. My age grew up on Whole Foods. Sorry so long but I’ve walked a tight line. No smokes. Take NMN,NO, K2 D3, Krill oil. Have all my body parts
Thank you so much for this interview! I am now 56 years old. Menopause at 46. Bruh! Them hot flashes ain’t no joke! Also osteoarthritis! Have changed my diet! Weight training! And my Doc has tried 3 times to talk me into stopping my hrt! I did try twice, hot flashes were brutal! She 1:14:02 has since stopped thank goodness. And I have no desire to ever stop. Otherwise, I’m perfectly healthy, do all my yearly screenings. And I really would Like for someone to help me with this arthritis! I don’t want to die of a hip fracture like my great grandmother!
I’m 32 years old and started reading part I of your book some hours ago and right off the bat, thank you for putting it out there. Against my doctor’s wishes, I had a basic check of my vitals because I felt something was wrong with my chest. Blood work came back saying I’m pre-diabetic. Can’t wait to learn more about this in your book and how to structure my diet and exercise to fight this.
go low carb + 1g per lbs of bodyweight per day in 3/4 meals, resistance training 3x a week, cardio 4x time 45' per week, and your pre diabetes will magically disappear.
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I have been forwarding your last conversation to my friends, nurse co workers and family members at my work assignments who express interest. Thank you for those discussions and providing this information. I decided to get hrt and am very happy with my decision. I see a lot of older women patients with bone fractures and dementia. I often wonder if they had more complete information if they might have made different choices and perhaps maintained better bone, heart and brain health.
Honestly hot flashes and sweats are the least of my concerns. What about mental functuons, brain fog, memory loss, etc. And what can we do to avoid that bone denisty loss? I never wantbto stop HRT if my bone density will drop.
Thanks Dr Attia for at least bringing up this issue, we never hear about. I have listened to several podcasts and also read sbout the failings of the Women's Health Initiative. Based on my own research, I feel this guest was a bit biased to the WHI considering she analyzed the data. Specifically there is a huge problem with the health of the sample. Most women in their 60's with significant health problems such as high blood pressure, smokers etc. How does this translate in any shape or form to healthy perimenopausal/menopausal women in their late 40's/early 50's with menopausal symptoms, considering most of the women had gone through menopause or had no symptoms?? I wish this podcast had gone more in depth in the protective benefits of estrogen against cognitive decline and bone health. The same number of women die of hip fracture as those who die of breast cancer. An excellent book, "Estrogen Matters", by Dr Avrum Bluming and Dr Carol Tavris highlights some of these research findings. Dr Barbara Taylor is another excellent source, here on You tube. Both that book and her findings have saved my life, with bio identical estradiol and progesterone for sleep and hot flashes. Please consider interviewing these clinicians in upcoming podcasts for women's health.
I started total menopause with 40yrs. my symptoms were very strong and interrupting my live. At that time there were only the horse urine and synthetic hormones available which I refused to take, changed a lot around my diet to relieve symptoms, helped a bit also lots of supplement and Acupuncture but it was very limited in relieving symptoms. after 5 or 6 years bio identical hormones were available. I was not very functional in life without it. I was soooo happy .Live became livable again. I exercise very regular[ Daily] and eat a very healthy diet have all the regular test done and increased my spine density 3years ago by 8%.I am 76years old still work parttime, do all my yard work and Gutter cleaning. I had no choice not to take it and have done with it very well.
I was suffering with symptoms for AT LEAST 6 to 8 years prior to being diagnosed with endometrial cancer last year. I went to my yearly gyn exams and dr. would say, everything good, see you next year - year after year. Despite the fact I sat there and complained every year to him, I was not feeling well. My doctor never not one time offered me hormones after listening to how miserable I felt. It infuriates me to this day.
@@Mychellechic I went to year gyn appointments for your typical exam. I would sit there and complain year after year with symptoms and the GYN never once offered me bio-identical hormones.
Apparently some drs have a code name for us "WW" - whining woman! So infuriating! 😡 I, too, have had my life severely impacted by menopause and 'scared' to get HRT because of a family history of breast cancer. I'm heading to my Dr as soon as possible and demanding treatment. I'm so angry.
I have had doctors trained in S. Africa and Australia. I have been on compounded HRT Bi-est and natural progesterone for 25 years. I'm now 64 ears old. I check in with my doctor every month. I have never gone through menopause. I have have younger looking skin to those compared to others my age w/o HRT. My energy is high, I have less depression and emotional lability. I work out daily, have a positive attitude and my body is still muscular and no weight gain. I was told by my women's health specialist I can stay on it well into my 70. i had a hp replacement 2.8 years ago. I have recovered with minimal medication. I have improved my strength and stamina is amazing my surgeon and phystiotheapist.
I was afraid of HRT because of breast cancer risk and have changed my mind after listening to another one of your episodes and getting to know I wouldn't need progesterone, since I don't have an uterus. It has changed my life. I had been suffering from menopause symptoms for years. My sleep was ruined, my insulin sensitivity was ruined. Thank you for informing us!🌻
Hrt can contribute to breast cancer, i had no genetic or family history and developed breast cancer on bio identical hormones. After mastectomy i asked if it was ok to go back on hormones and it was a firm no from whole cancer team. Messages that it’s harmless is dangerous because we all react differently and the truth is it’s a risk you need to be aware of when you make your decision to take it.
@@kp-gh7nn i had triple negative breast cancer, but Moffitt Cancer Center and MD Anderson still say I cannot go back on HRT and I was on bio identical hormones and oncology says no way.
I really appreciate that Dr Joanne Manson gave this interview and you were able to go into depth to understand what the heck was going on with this study. I don't understand why the cost of running another 8 or even 30 year study on HRT couldn't be justified. And I don't think you can say that you can't justify it because the HRT medication in the study will have become obsolete after 8 years. Surely scientists know how to structure a study that accounts for this. We are 50% of the population and we have a right to have better knowledge about the benefits and risks of HRT long term. As a woman approaching menopause I need accurate answers on HRT risks.... A lot of us will be going ahead with HRT long term because frankly there are too many negatives without it. So we are leaving being left in the dark on this. For me personally I would like to take HRT while doing heavy strength training to maintain my bone density. I'm currently recovering from a fractured foot and I do not want to be negotiating fractures as I get older.
THIS exactly. When she mentioned it would be too expensive to do another study, she told me that she believes that women's health isn't important enough or worth spending money on!!! I was shocked to learn that a significant amount of medical research has only been conducted on men and that women are thirty percent more likely to die from medical mistakes than men. Women definitely need more medical research!
Thank you! This podcast was wonderful. Yes, I am one from that generation of women fearing hormone replacement causing cancer. Now I’m on BHRT. Thanks again
Peter, I’m glad you interviewed her. It’s more than obvious that she’s still of the mind set of the ‘old ways’, whereas YOU, are more progressive in your thinking and I’m guessing, treating of people. I wish there had been more emphasis placed on the fact that this entire debacle of the WHI was ALL synthetic hormones……not bio-identical. That fact in itself is still confusing to people. And I’m glad you kept pushing and emphasizing the benefits of HRT.
The situation has led to a degree of perplexity. I believed my understanding of BHRT was firm, yet I wonder if the matter pertains to the differentiation between Progestin and the utilization of Progesterone. At present, I am undergoing oral progesterone treatment to address menorrhagia during peri-menopause, given my age of 48 years. I agree, we most definitely need another study with current BHRT’s. I greatly appreciate your sharing such enlightening videos. I have been dedicatedly studying the intricacies of menopause for the past few years, diligently preparing for its eventual onset.
I've read through the comments and I see the frustration with her repeatedly saying that FDA approved HRT is probably OK after careful consideration of all the risk factors for hot flashes and associated menopausal symptoms. She is clearly staying in the FDA approved lane and understandably not recommending a medication for an Off label use. I understand everyone's frustration and I think she could have just stated for the record that she was not going to recommend an approved medication for anything other than what the FDA stated. She is a high profile researcher and clinician, probably on the pay role of a few pharmaceutical companies. She has no other choice. There are very serious consequences for recommending mediations for off label use. This actually might be an interesting topic unto itself.
Why isnt the estrogen window discussed. ? She keeps talking about night flashes but what about osteoporosis, Alzheimer’s and heart disease? Is this really not fully established?
This was very informative, thank you! Any chance Dr. JoAnn Manson would come back and talk about thyroid health? As an endocrinologist she would be a wealth of information. Thank you again for this podcast.
NO Questions ****women need NOT BE DENIED estrogen!!!! Not educating women on estrogen therapy is a terrible blow to women and it’s insulting that clinics are handing it out to children instead of post menopausal women!!!!
Women need to have open resources to cope with Post Menopause. They need Hrt therapy resource centers, and until we are in a place were women are able to get hormones and education that needs to come first. It makes me sick how there is so much info for children on hrt . When there is zero for women. The medical system is failing women!!!
One thing that I haven't heard discussed on this topic is the impact of birth control for many years. I was on BCPs from the age of 15 to 35 when I was told I had to be taken off it because of the increased risk of blood clots. I never had any issues being on the pill but I have had endless issues since. I had a tubal at 35 as well and I don't know if it was the tubal or going off the pill that caused my issues but I ended up with extreme bleeding after that that doctors shrugged off for a decade. Eventually I found a doctor to do an ablation to stop the bleeding and that was great for a few years until what I assume is menopause started. It's been so awful with hot flashes, night sweats, mood swings, brain fog, dry skin and more I'm sure. I'm thinking there is a connection here to controlled hormones for so long and then none set my body into a tailspin. I wonder if it's too late for HRT? Will it help me after all this at 58? Another thing you should talk about is how we found out in the 80's or 90's some time that for decades they never even did research on women, they just assumed we were just like men.
My gp wants me off hrt due to risk of breast cancer reoccurrence..im 67 and i dont want to come off it ...i had a grade 1 tubular carcinoma breast cancer seemingly with low reoccurrence rates ..whats your thoughts please please?
Thank you Dr. Attia for having this important topic of HRT. This discussion helped validate my recent one month use of Estrodial patch .025mg with Progesterone. Overall, it's helped me feel better mood and happier. Hasn't quite helped with hot flash but i might have to kncrease dose. Very helpful discussion. Also the osteoporosis aspect is an eye opener. Thank you.
1)Had TIA from birth control 2 decades ago. 2) lumpectomy-benign during teen years 3) stage 4 endometriosis 5) maternal breast cancer 6) surgical menopause since 2020 from emergency surgery for removal of cyst, w/o any HRT-was not advised 7) now cholesterol is high 8) LDL high 9) A1C 5.9 all time high 10) belly fat increase 11) muscle mass reduction 12) herberdens nodes forming. .13) can no longer run 14) Took me three years (after orilissa treament in 2020 after hysterectomy to treat endo) before i could finally do 3 sets of bicep curls with an 8lb weight..i feel like ive been put on a fast track to my grave. All the info has many overlaps and one contraindication can cancel another issue and vice versa. Can someone, anyone, please help me navigate, I'm so freaked out and confused but i want to live to see another day , I have a family, I am 53. It's like being the subject of mean joke and only getting worse.
This frustrates me so much. I am just short of 68 and have been on BHRT since 51. I have ZERO history of breast cancer. My bone health is awesome for my age. I don’t want to stop taking hormone replacement ever! And yet, doctors here in Portugal won’t prescribe it. I don’t want my bone health to decline. I don’t want my cholesterol to go up - it has always been in a very healthy ratio. And I am willing to live with these slight risks she spoke of. I fast several times a week, (sometimes 36 hours,) walk and exercise. I try to taper off Progesterone and I can’t sleep! I’m having vaginal atrophy with pain and burning. How will this get any better with no hormones?!
In the states doctors can prescribe to anyone. It can even be done on line. Bioidentical hormones should be within your reach that way. You might need to have someone ship the hormones to you.
Everything is risk versus benefit in life and I feel the benefits of HRT far outweigh the risks. We replace insulin, we replace thyroid, we replace hydrochloride acid, we replace digestive enzymes, why would we accept the loss of hormones? At first that’s what the doctors said, this is normal for menopause. Well it wasn’t MY normal. People owe it to themselves to try anything that is reasonable to maintain their all over health
The Pharma industry wants women to get the three diseases of menopause, heart issues, bone loss, and dementia, so they can peddle their expensive drugs instead of the CHEAPER HRT. Follow the money.
There are so many reasons why the study participants could have gotten breast cancer and heart attacks etc. Statin increase from 7% to over 50% during the study, their sugar and carbohydrate consumption which could feed any cancer cells, etc. So many variables. It’s a disgrace really that we women have to go through this drama and anxiety about what we can do and what we should be doing and have to fight for our HRT scripts like we are doing something negative to our health, while the medical profession is happy to give out statin scripts Willy Nilly etc. Peter is an amazing Doctor and I loved his comments particularly his summary at the end of this interview.
Also, take a look at what happens when you take oral estrogens as opposed to transdermal estradiol. Estradiol actually lowers risk of breast cancer and is highly anti-inflammatory.
I remember reading a 25 year study of nurses nationwide in the 90s (quickly scrubbed from the internet), which showed women, like myself, who had hysterectomies in their 30s and 40s, before menopause, who waited until the onset of symptoms (sweats, hot flashes) which were typically two years post surgery, and who then went on bioidentical estrogen replacement. That group, the only one, had zero incidence of breast cysts or masses of any kind, and zero cases of breast cancer. I've been on a quite high dose (claims every doc, even though I use the minimum dose that relieves symptoms) for 40 years. I only allow breast ultrasounds (don't want cancer from mammograms), which confirm the continuous healthy condition of my breasts. My last doc just died, so on to find my next, and hopefully, last medical opponent to my being "allowed" to live symptom free. My body my choice.
I feel this episode was wasted and as a regular listener I feel the same thing was said over and over. There was one very interesting point that Peter was trying to make about hip fracture incidence reduction. It sounded like he was saying that the study was only powered to detect incidence in hip fracture and not mortality, but if we were to extrapolate based on general hip fractures there would be a huge mortality benefit from decreasing hip fracture incidence, and this reduction would presumably still be a large net benefit over any smaller risks from HRT. The guest completely avoided engaging in this type of intellectual discussion though, it was so frustrating. I also feel this episode should have talked more about HRT and why so many people are interested in taking it. There is a belief in the general public that HRT can partially restore a youthful mood, energy, and sexual function. And more generally, people think that because sex hormones decline with age, HRT feels like a smart general wellness option. Peter should be addressing these ideas, even if it is just to say which parts are naive or not evidence-based. The ideas are too big in the public's mind to ignore.
In the study, 16,000 women took estrogen plus progestin and 385 of them were diagnosed with "invasive" breast cancer. How many diagnosed with "non-invasive"?
Please get Dr Louise Newson on a podcast . She seems to know alot more updated and relevant information on HRT and the many symptoms than this woman ! Menopause does not just cause sleep problems , hot flashes and night sweats 🤔😞
My mother participated in the Women’s Health Initiative in 1995 at University of Alabama in Birmingham (UAB). She was an extremely healthy 65 year old when she started the study. 7 months later she was diagnosed with a 6-7 cm tumor the size of a small grapefruit that originated in the ovaries. She died 3 yrs later. My mom was not in the placebo group and she was immediately dismissed from the study. All this made me very weary of HRT but after much coaxing from my OB/GYN I decided to take bioidentical HRT. I do get vaginal ultrasounds every year just to make sure there are no visible tumors. My Dr. assures me it was from the “estrogen dumping” that was done in the study. Still miss my mom and wonder if she might have lived 20+ years or more without the Women’s Health Initiative.
The comments in here are golden / invaluable to every women out there ! But also for practitioners / scientists in facilitating resolution to those suffering/really suffering… Docs need to give us all choices ! Like another lass said it’s our body /our life) …. And someone mentioned dementia in here which I’m not sure was touched on much in this discussion - but is huge ! The menopause and it’s detrimental effects on the brain. Lisa Mosconi (neuroscientist) has done so much work on this topic and claims the significance of taking HRT to stave off dementia is huge. But ultimately it’s down to quality of life in the time we have and as many women on here have said the symptoms of menopause can be horrific !! For me sleep deprivation ruins your quality of life /ability to function mentally & physically- everyday is a struggle, but HRT alleviates on so many levels. We of course are all different and we all need different solutions but we ALL need the choice . Xx
Peter Attia's point that the hormone replacement estrogen what progesteron estrogen therapy continue to the seventies can reduce incidence of hip fractures is important. I would also like to know what kind of therapies if any can be use to reduce male hip fractures in their 70s and 80s.
After a radical hysterectomy, I had HRT, first by pills, then patches and then creams, for estrogen and progesterone. They all made me ill. Got off all of it, and I gradually felt better.
You were GIVEN POSION ..ON PURPOSE.PHARMACEUTICAL CRIMINALS not given BIOIDENTICAL HORMONES REPLACEMENT THERAPY..NOT COVERING BY ANY INSURANCE. I WAS SAME POSITION ONCE I SWITCHED TO BIHRT IT CHANGE MY LIFE BACK TO NORMAL
Some women don’t tolerate the progesterone component of HRT and don’t feel well at all on it. I wonder why you were prescribed progesterone, since it’s only a requirement for women who still have their uterus. Perhaps it’s possible, the progesterone was the “problem” in your case.
@@cm1906 I was prescribed estrogen first, couldn't tolerate it, then taken off estrogen and put on progesterone, where I couldn't tolerate as well. This happened 3 decades ago, so (I hope) medical science has advanced since then.
There is limited research on the risks of strokes, dementia, and heart disease associated with estrogen patches with a progesterone-coated IUD. However, two studies did not find an increased risk of these diseases in women who used this combination therapy. 1."Estrogen patch and progestin-releasing intrauterine system for postmenopausal women with non-estrogen receptor breast cancer: a randomized clinical trial" (2022) by Moyer et al., published in the journal Cancer. This study was a randomized controlled trial, which is the gold standard for medical research. 2. "Estrogen patch and progestin-releasing intrauterine system for postmenopausal women with non-estrogen receptor endometrial cancer: a randomized clinical trial" (2023) by Neven et al., published in the journal Obstetrics & Gynecology. This study was also a randomized controlled trial. Both studies found that women who used estrogen patches with a progesterone-coated IUD did not have an increased risk of stroke, dementia, or heart disease.
Bravo and thank you for addressing HRT. I had a complete and elective hysterectomy in my early 40's. I was placed on estrogen and ultimately testosterone. Prior to and after treatment I would participate in endurance sports (Ironman, swimming). At one point and new internist took me off testosterone. I went from running the Chicago marathon to not being able to run a mile (and taking several days to recover). I begged the doctor to put me back on. No body would and I reached the point of telling the doctor that I was a transgender male. I knew that endless amounts of testosterone would be given. I did not do this as I wanted a relationship with a doctor. Anyhow, I thought that i was going crazy. I went to a psychiatrist. He referred me to an oby/gyn and without I fnishing my sentence, she understood my problem and placed me back on testosterone (estro-test). My prior engergy never fully returned however, now I can run a 5k (before i over heat). I continue swimming(masters). I still struggle with mild fatigue and a decrease in motivation. I was off testosterone for two years and the experience was horrible.
It was irresponsible of the doctor to take you off testosterone in the first place! You present dosage is too low from the sounds of it. It irritates me that being prescribed hormones is very difficult for most of us yet doctors will willingly prescribe massive doses to people far too young for any form of hormone treatment if they say they are transgender, ruining their health and hormonal profile for life! Hypocrites is a good name for these Doctors.
I read somewhere that there was nearly a billion dollars spent on this study. One billion $$$$. That can only mean the scary "you will get cancer!!!!" outcome was worth a great deal more to them.It was the outcome they wanted. While HRT is valuable to women's health and QOL. But not providing HRT is way more valuable to the medical industry.
I’m 65 never taken or considered HRT, listening by chance tonight.. I’m just left confused… sounds like I’m in higher risk age group, I’m experiencing pain & brain fog..
How about doing a discussion about "Older" women 70's & beyond, using hormones. I just read the book by Becca Levy " Breaking the age code" Now I see Ageism everywhere! Getting older will effect EVERYONE (if you're Lucky! ) I wish everyone would read this book (Especially Doctors) It's a real eye opener!
Was iron loading considered a confounder in the difference in the onset of heart disease between men and women and could that also be the increase of all cause mortality in post menopausal women. The oxidative stress caused by the increased iron levels has to have a significant negative effect on health once a woman's period ends.
Wow this was amazing!! Thank you so much for sharing this incredibly informative interview..🙏🏼 Still I find that most interviews don’t really touch in the intravaginal HRT, I will look for that in your channel, hope to find it 🤞🏼🤞🏼
She reports that risk outweigh benefits as we get in our 60s-80s but was this really studied? Its true for women who are started on hormones that late but do we really know that the prolonged use increases risk?
I know there is research suggesting starting within 10yrs of menopause showed benifit..but after 10 yrs increased risk. Sorry i dont recall source. But research it.
YES!!! Agreed. And what the heck I have like 5 more symptoms and haven't had night sweats or hot flashes at all!!! How about anxiety, depression, joint pain, paranoia and belly fat! The other symptoms weren't even mentioned. 😢😢
It's so irritating to hear her go on about hot flushes and night sweats as if they're the only troubling symptoms. So many women have taken their own lives because they found menopause so hard and ended up with depression and anxiety. For me, I had terrible heart palpitations and crippling anxiety when I started perimenopause and taking HRT has been life changing. The depression, brain fog, increased heart disease risk, lower bone density risk etc etc surely outweighs the extra one case in a thousand of breast cancer, which may not even affect mortality!
38 and in surgical menopause due to cancer and I swear the joint pain, fatigue, and brain fog have given me those thoughts. Especially the joint pain. I honestly can’t live with it. Thankfully HRT has eased it off but before that it was literal hell.
Absolutely! Menopause is not just about hot flashes. Depression and anxiety are serious, life-threatening symptoms for many women. Women who have had a hysterectomy and "don't need progesterone" are often the ones suffering from anxiety, depression, and insomnia, even if they do get estrogen.
Is there any evidence or data available on how long one should be on HRT? Do the risks of breast cancer and/or uterine cancer increase the longer one takes HRT? I've been on it since 47 and i'm 54 now and i wonder how long to continue taking it. I feel good on it with some slight spotting here and there, with no health history of any cancer at all. Can I take it forever or is there a stopping point?
You shout be able to take it indefinitely. You need your hormones. Estradiol has rather showed to help against breast cancer ruclips.net/video/klLKxLSzF8s/видео.html
If you listen to the podcast you can find an answer: risk is very low in early menopause but increases with age. So there’s some stopping point, maybe 60 or something.
There is a small increase in breast cancer. But heart disease kills way more women than breast cancer and hrt helps alot. Take hrt, eliminate metabolic syndrome causes and hrt will improve your life . There is no coincidence there is no dementia and very little breast cancer and osteoporosis in premenopausal women. If you eliminate smoking and metabolic syndrome, you virtually eliminate these conditions.
i have watched the entire podcast and she does say that we can "assume" the risks go up as we age, but why is that? Doesn't the risk of everything go up as we age? Like Peter said, the risk of dying from a hip fracture after 65 is a lot higher than the risk of getting breast cancer. I guess there really isn't any reliable data from studies on HEALTHY women who have been taking ONLY bio identical hormones after 60??? I am 5"6", 125, and have been working out hard for over 35 years! i eat very clean and rarely drink. I am not the average woman. I guess i would like to see some real data on women who have been on HRT (bio identical), have no history of cancer or heart disease, eat well and exercise (strength train, cycle, hike, yoga) and see how HRT affects them AFTER 60. I just wonder if I have to stop taking HRT at 60 or i can keep taking it as long as I'm getting screenings regularly.
So is the takeaway that if there is breast cancer in your family (mother) and in your late 40s / early 50s and in menopause, that the risk ratio is higher than the 1:1000 quoted here (if women weren’t excluded from the trial with this situation) and therefore STILL not recommended to go in HRT even if they are suffering terribly with hot flashes and night sweats it’s effecting their/their partners sleep and wellbeing? That’s the reason we were listening?
What if I’ve been taking BHRT since 2003 or and learned I had endometrial carcinoma-E+ and P+ type.. Then a total hysterectomy which cleared the existing cancer that had not metastasized. Now, as I don’t need opposing progesterone, the doctors say no more estradiol patches either. I have managed osteopenia and hypothyroidism, mitigated with and Vitamin D3 and levothyroxine Ii miss the benefits the estrogen patches provided. Now what? Am I doomed to increased frailty and brain fog and increased cardiovascular concern? Plus my sleep is very disrupted and I do get some vasomotor symptoms I didn’t have before, among other things. Is there any clinician reading this that thinks it’s ok to restart with an estrogen patch after having had endometrial cancer? I just had the surgery in mid-July and it’s nearly October. As I said, there is no evidence of remaining cancer. I’ve never had breast cancer or anything else. I am just shy of 70. Please provide some thoughts if you are an MD or DO, particularly in gynecology. Thank you.
I have a recent history of very low grade, very small breast cancer. I can’t find a doctor that will let me chose an increased risk of the return of breast cancer in order to prevent the very risk in my family of Alzheimer’s and heart diseases. Instead my golden years will be spent not sleeping, not getting off my couch, suffering from anxiety attacks, hot flashes and memory issues. My family will have to take care of my Alzheimer’s like I didn’t for my mother who passed 7 months before my breast lump. My mother’s mother also died at age 60 from early onset Alzheimer’s. There is no cure.
I also thought it was interesting when they stop the trail because of heart issues. She just blew it off and focus supposedly all the good things that took place. It sounds like she was just saving face.
This whole thing makes me so angry, especially when the docs focus on hot flashes and night sweats. Yes, those are no fun, but my symptoms were much, much worse. I felt like I was falling apart mentally, physically and emotionally. I had almost all of the symptoms mentioned in the godsend of a book, Estrogen Matters. I would’ve given up 10 years of my life to feel better and be functional. I would’ve had a prophylactic mastectomy if that’s what it took. No doctor would prescribe estrogen for me because I had a stage 1 breast cancer in 2015. I’ve been cancer free since then and I understand the supposed increased risk in a recurrence (which I don’t necessarily buy.) In any case, it should be my choice - it’s my body and my life. I was lucky to find a friend who was willing to prescribe estradiol patches for me. My quality of life increased 10-fold in about a week. They can pry my estradiol patches out of my cold dead hands. I intend to stay on estrogen for the rest of my life. I believe that starting early will help prevent the conditions that are more prevalent in older age. I agree that it is sad that millions of women suffered unnecessarily since 2002. What about the millions of breast cancer survivors that are currently suffering? Dr Avrum Bluming has an article that goes over every study regarding estrogen after breast cancer and I am convinced that the current “contraindication” will someday be shown to be wrong. Even if there is an increased risk of recurrence, I am willingly taking that risk. Who wants to feel like hell for 25-35+ years of their life? Not me.
Agree 💯 I had all symptoms thought I was lost I found it have to work second job to receive it but still worth it
amen sister. Slightly increased health risk, somehow that is more important than the fact that I was 100% miserable and barely able to function. Everything has risk. Viagara has risk but men are allowed to weigh their own risks and make their own choices when it comes to that. we women are supposed to suck it up,”it’s normal honey” when it comes to feeling like hell in menopause. I finally got my estrogen patch and within 2 days I was back to normal. alcohol and processed foods and cured meats are far more dangerous than the damn estrogen, but no doc every tells you that. Whatever X% health risk I get from HRT, I got back several times over by eating a whole food plant based diet.
For those who were denied estrogen for hot flashes did you try the other meds like the SSRIs, Clonidine etc? I found that my hot flashes are made worse by electrolyte imbalance/dehydration.
I am 45 and starting to feel like hell...feel sore, achey, night sweats, low mood...I'm young but it's starting already.
This was so confusing.
Started HRT at 58. DEXA scan prior to HRT showed osteoporosis and osteopenia. After a year on HRT osteoporosis now osteopenia and areas of osteopenia now normal bone. This along with other benefits of HRT have been amazing.
That is so encouraging! Did you do anything else like take calcium or weight bearing exercise? I’ve heard those measures don’t do much if you have no estrogen. I would love to have those results. I had a similar improvement when I was on it but then I had to get off after breast cancer. I’ve just restarted!
So good to hear this! I am starting bio identicals. I have osteopenia and osteoporosis in spine. This is encouraging!
@@rosiet253 Progestin the patented synthetic form of progesterone can cause breast cancer yet this garbage is still prescribed rather than natural progesterone
Yes on the weight bearing exercise and I’ve been taking AlgaeCal Plus at the recommendation of my MD. You have to buy it from the company. On the expensive side unfortunately.
@@vickydavis1757 I’ve looked at that? Do you use the strontium too?
I had a full hysterectomy at 42, went on HRT immediately & now at 61 I’m still fit, strong & super healthy… love my HRT 👍👍
I’m with you -- hysterectomy at 23, still on ERT at 72, riding a bike thousands of miles/year, hiking, strong, lean, and healthy!
You never took progesterone?
@@04Serena did you ever take progesterone ?
I tried it twice, but it caused brain fog and some bloating, which is opposite of what many women report -- so I stopped it. I obviously don’t have to take it, as my uterus was removed.
@@04Serena What kind of HRT? I had a hysterectomy about 8 years ago at 55. I first went on an estradiol gel, but switched to the oral because the gel was so expensive and my insurance paid very little of the cost. the oral is so inexpensive that even without insurance it is affordable, I need to look into the bio identical type. I don't even know what makes the biodentical different or how expensive it may be. I too intend to be on HRT until I die from what ever cause. Quality of life is more important to me than the length of my life. With this said, my bone scan a few moths ago did show that I had osteopenia, so hoping i can turn that around with supplements and weight bearing exercise, I.E. walking and some light weight lifting (due to my muscles seeming to going away).
I'm a doctor and although I'm not in the same specialty, I'm very interested in the topics you discuss. The topic of HRT is extremely important in my opinion for women's health. I would like to kindly ask you to consider hosting a future podcast with an expert in the field and delve into the science and the benefits and risks of HRT as made evident by the latest research. I find your podcasts of great educational value not only to the general health conscious public but also to clinicians concerned with the well-being, longevity and reduction of all-cause mortality of their patients. I really value and appreciate your educational and research work, thank you very much and I look forward to listening to the podcast on this topic in the future.
Do your patients a favour and never prescribe progestin, only natural progesterone.
@ronaldharrison7742 only if you have your reproductive organs , I was given it after hysterectomy and had such swollen sore breasts. Premarin works for me .
@@jenn1fermeyer468 Premarin, meaning from horses urine may well help you but I am talking about money making Progestin being used as a replacement for natural progesterone..
Why no info on Testosterone????????
I truly want to hear about testosterone treatment on menopause.
60 this year .. started HRT last fall.. Tremendous benefits including being able to orgasm again after not being able to at all for several years due to an antidepressant. The affects overall have been so good I'm now weening off the antidepressant! It's good to feel alive again!!
Are you also taking/using testoterone? If so..what is form?
@@cynthiahansen2341
I have pellets in my hip of estrogen and testosterone. Oral progesterone..100mg.... Originally doc prescribed me 200 but I've never smoked or drank or done drugs so I'm an extreme lightweight in that department. It was knocking me out... I've since tweaked it to the 100 mg and I take it about 6 p.m. so I'm nice and drowsy come 9 -930 which is great for me. This way it's completely worn off by morning and I have my energy back. If I forget to take it early I just don't take it at all because it does keep me kind of sluggish in the morning if I take it late. But again I'm a real lightweight!!
I had pretty good sleep hygiene before I started on the progesterone but this it's been the icing on the cake! I sleep with the house on 62 and the ceiling fan going. I sleep like a baby now... Even on the nights I miss taking it.
I also don't eat after 5 in the evening which helps with my sleep. I also consume zero sugar and keep my carbs very low. I have zero aches and pains between the diet and the HRT.... 20lbs fell off of me.
I haven't felt this good in a couple of decades, mentally emotionally and physically.
If you have any questions about the sexual health benefits of it just ask I'm an open book.
Not sure where you're at but I'm in the Waco TX area if you need a recommendation fo r a doctor. I love him and his staff!!
@@theflamboyantgrandma1890 thx so so much! I am in utah...and a widow..so not too worried about that aspect..but more concerned about brain health an memory. I have done all those food things. Take quality supplements an nootropics. Now started experimenting with herbs for memory etc. (Personal lost 21 daughter last summer so hard to place exact cause of no motivation) want to up my testosterone for brain an drive?
@@cynthiahansen2341 so sorry to hear that but so glad to hear you seem to be on top of it!! Keep up the exploration and the motivation will come!
Would love to know who you see! Im in Austin area.
THANK YOU DR. ATTIA for posting this important topic. HRT saved my life. I started getting panic attacks and memory loss and depression. HRT resolved all of my issues!!!
What kind of hrt? Estrogen and progesterone? Or testosterone as well?
So encouraging I have an appointment to discuss HRT. I can’t wait to start it
Dear Dr Attia,
I would like to propose a (perhaps) new angle in approaching the topic of HRT in peri- and post-menopause. I would love it if you had a guest who can take us into estradiol’s role in ALL the organ systems of a woman’s body where this hormone has functions, and preferably into a level that goes beyond “estradiol is good for the bones, heart and brain”. I have heard that there are estrogen receptors in every organ system of a woman’s body, meaning estradiol serves many purposes beyond the reproductive functions …
I would really like a more detailed lecture on what estrogen does on a cellular level to keep a woman’s body functioning optimally. I would like to learn, what happens to those bodily functions when estrogen is no longer produced by a woman’s ovaries.
Once we understand all the important roles of estradiol (and progesterone, and testosterone) in the female body, we can ask why we are not viewing and treating it as a hormone deficiency like any other (thyroid hormone, insulin, vitamin D)? Dr Louise Newson in the UK, for instance, works tirelessly in this area, to have us understand menopause as a “long term female hormone deficiency with health risks”.
Ideally, it should be a woman’s choice whether to take hormone therapy for her quality of life and to help prevent important diseases.
Well said. While we’re at it, let’s understand exactly what natural levels of progesterone and testosterone do at a celular level throughout a woman’s body…if science has even explored this question.
Dr Barbara Taylor on RUclips is a great resource for information
Quite right, have you ever wondered why Doctors seem loathe to have ALL your hormones tested? They likely know that correcting them will cure a multitude of your issues with them being unable to prescribe profitable but harmful drugs.
@@marinasolt6232 We already know this. The natural levels in your early twenties are your optimum levels, it does not take rocket science to determine an average using a large enough number of people and so calculate a beginning dosage for you to return you to those levels.
I love Dr Newson so much. She’s an incredible human.
I had a hysterectomy/oophorectomy at age 23 and was profoundly symptomatic afterwards. I was initially prescribed Premarin, but after learning about liver cancer risks, transitioned to transdermal. I’ve been on ERT for 50 years, and at the age of 70 , had a hard fall from a road bike directly onto my hip, hitting so hard my hip turned black -- but no bone damage... I have great bone density. Symptoms controlled by a little patch include migraine, PVCs, insomnia, soaking sweats, labile moods, formication, and insatiable appetite. Symptoms improved but not fully relieved are dry eyes and mouth, memory issues, and anxiety. I’ll be on ERT till I die, even if that comes earlier than it might otherwise.
I was not a fan of this guest. She was a tad defensive about the WHI and still projected fear about HRT. She brought up antidepressants as an effective alternative?? I guess if you’re clinically depressed, but why else would someone take a drug that alters brain chemistry and promotes weight gain. I think there are better experts out there: Susan Davis, Heather Hirsch, Barbara Taylor, to name a few. But Peter Attia is doing a wonderful job of highlighting overlooked women’s health issues.
She defended the study because she was involved in it. That makes her opinion biased, IMO.
From the hours I’ve spent reading studies If a woman takes estrogen only her breast cancer risk goes down. But her risk of uterine cancer goes up
If she takes both estrogen and progesterone her risk of uterine cancer goes down and breast cancer has a slight increase
But estrogen and progesterone also lowers risk of osteoporosis , heart disease and newer studies show also decreased risk of dementia. Not to mention overall happiness about life and being able to sleep. Seems the benefits outweighs the risk
Great topic!! Though I'm 68, in that group that "was denied" HRT, still suffering greatly and would like to start HRT, which I likely will, but would LOVE for you to discuss older women starting HRT. Quality of life is EVERYthing--for me anyway. ;-)
I treat post menopausal women of any age. My 92 year old mother is on topical testosterone, and is still teaching water aerobics
You have rights!! This makes me so angry! You have more of a right to estrogen than a child!
I started back on HRT at the age of 68 after 20 yrs of misery and increasing health problems. I have reversed my hypertension, my cholesterol is back to normal, I’m sleeping well, I’ve lost weight, and reversed my osteoporosis. Just to mention a few things. Brain fog is much improved. Anxiety levels are way down…. And on and on.
Same! It's as though we've been relegated to take a walk in the woods. My worry is especially for osteoporosis.
The way she talks is confusing. She keeps contradicting herself.
Chiming in from Canada 🇨🇦 Can’t thank you enough for providing this unbelievably critical information. Just started HRT. Estrogen & progesterone. I’m already feeling a million times better! And finally sleeping. Thank you so very much 🙏🏻
Thank you Dr. Attia for your support of Women’s Health! It is so sad to me as a Registered Nurse that women are being denied by the medical community of a treatment that can and will improve the quality of their life. I’m 52 and have been denied HRT by 2 providers so far. I am saddened and shocked at the ignorance and lack of knowledge that most medical providers have on HRT. Thank you Dr. Attia for raising awareness! God bless.
This episode illustrates the power of persuasion and being a good orator. I have listened and re-listened to this podcast and if I were to exclude Dr. Attia’s commentary, I would believe that HRT is still dangerous and the only benefit is to reduce lost sleep and hot flashes due to menopause?!? Perhaps it’s her monotonous tone or fear of implicating herself by stressing the positives, though honestly this detracted from me looking into HRT unless absolutely necessary. I think you need a guest that stresses the positives backed by clinical data. If the intention was to get people to re-examine the controversial women’s health initiative and not fear HRT, it missed the mark. Please have a guest on that can speak honestly to the positives backed by clinical data to support HRT. Her responses were like a politician answering questions…though in the end left the female listener still weary.
Ditto, I also would love to see a podcast with someone who doesn't have a horse in the race. It seemed the focus was on breast cancer, would like more info on heart health, stroke, cognitive issues.
Thank you for this comment! These were my thoughts exactly.
Agreed !
I thought the same thing. I thought it was ridiculous when she said a particular result “almost reached statistical significance.” So it wasn’t statistically significant. Sheesh!
Exactly!
I started menopause at 52. I am 59 now and just talked to my doctor last week about my hormones for sleep and bone health . This podcast was very interesting and I would love to learn more. Thanks for the timing of such an important topic.
I did listen and re-listen and again and Im actually horrified . Obviously amount of publications is not a best measure of quality of someones work . The lady and her team did properly messed up that studies over 20 years ago and she is still protecting it ! I mean , she is an endocrinologist and she prefers to put women on gaba antidepressants then HRT? Night sweats are only inconvenience? My mum was taken of HRT straight after thus studies . Strait after she put on 20 kg, she get osteoporosis and lost 80 % of hearing. Now she has vascular dementia …. Thank you Peter for introducing to me the woman who is partly responsible for my mums and my family suffering.
Shes a talking head for the "hellthcare"system and she doesnt even know it, because shes dedicated her life to being "right" about this study. She's full of a whole lot of "buts" Imagine being her patient, and she gaslights you into antidepressants (which are hormone therapy) instead of the proper hormone therapy needed. Makes my skin crawl.
I was taken off my HRT at the age of 50. In 2003. I’ve got osteoporosis with two fractured vertebrae. And dozens of other menopausal symptoms. Weight gain, awful anxiety and brain fog. Swollen feet so painful I couldn’t walk for more than 15-20 mins. Loads of other stuff. Horrible. I really felt I was physically falling apart. Not to mention the mental stuff. Not sleeping. And on and on. I went back on HRT after 20 yrs. Within 2 weeks my swollen painful feet went back to normal. My osteoporosis is reversing. I’m now osteopaenic. My anxiety is hugely reduced. I’m sleeping like a baby. So many other benefits including weight loss (yes I’m eating much better). My BP is now normal. My cholesterol is normal. I attribute all that to a proper eating plan as well as HRT. If anyone suggests o come off the HRT I’ll go through them for a short cut! 😊
I'm almost 50, and I'm on HRT for about 8 months. I am a very cautious"natural organic" person , and after taking natural suplements to ease my " pain," I knew that I would take HRT, just for my own and my close ones sake. I'm lucky that my doctor specializes in this field, and after some tests for blood clothing and stroke, I was on it and can not be happier. I think I did escaped that "Karen" stigma just on time. You do you, but when a nice person becomes a monster and you don't know why, then maybe you should consider that possibility.
Big thanks to Dr. P. Attia for his content, especially on peri/menopause issue, and for the book as well.
100% I couldn't agree with you more! I am 51 (almost 52) and I got lucky to work with a Reproductive Endocrinologist who keeps up on the most current information regarding cancer risk with HRT. I use Bioidentical Hormone Replacement Therapy.
Same! I’m turning 50 soon and it’s just now dawning on me that the series of mystery symptoms I’ve had for 2.5 years now is hormone imbalance. It took several people over this period of time suggesting I get my hormones checked to believe it! Because I have normal periods. But 6 months ago the mild hot flashes started and now my immune system is in the toilet. Still, period completely normal. Doing my research now and probably going to take the plunge asap. Glad you’re feeling better!
My OBGYN laughed when I asked him about HRT, I had been on it for over a year but just wanted his input. My first thought was ignorance !!
Hello there, from Romania! I really hope that by the end of listening to this podcast, I can make a more informed decision about HRT when it will be the case! Many many thanks to Peter and JoAnn❤🙏
Hi also from Romania 😊. I have not found a doctor that understand my issues. I have some relatives with breast cancer but also with type 2 diabetes. I entered perimenopause around the age 38 and since then I use the combined pill. Never used it before. I saw what a struggle diabetes is and I want to minimize it. I will look in other methods of HRT.
I take (Belusha) the pill 5 year now.
Peter is an exemplar of diplomacy with someone who--although as Peter acknowledges, has been one of few WHI investigators to openly speak out regarding the study's limitations--did not bite on Peter's opportunities to acknowledge the "limitations" of the WHI on a broader scale, but rather, fed listeners the same spiels repeatedly.
So true!
I’m post menopausal (56yo). I was told when I went into menopause that HRT was “risky and bad “. Therefore, I chose not to take HRT. Can I go on HRT at this stage? Now I have Osteoporosis treated with Fosomax and Calcium (k-d3-magnesium) for 5 years but unfortunately it’s not improving. Now they’re telling me I need to go on Prolia. No thanks! They can’t even tell me how long I can safely stay on Fosomax! I’m extremely healthy, great weight, no other illness, 3-4x per week weight bearing exercises and I eat very clean (ok, maybe ice cream and chocolate sometimes😂). I went hiking recently with my husband and was terrified the whole time I was going to fall and break a hip. All I hear from my doctors is “it’s time to slow down.”…WTH?!? I’m in the prime of my life.
get a new Doctor.
Watch the videos of the Doctors: Louise Newsom, Felice Gersh, and Marie Claire Haver. They have and do read and understand all studies and the bio and chem.
We deserve better than docs who think they are the deciders with inadequate knowledge. It was docs who got us 70yrolds into this hormone DEFICIENCY state.
i'll be d**mned if ill let them keep me there without good cause
I am.sp sorry to hear this ❤
Yes go on hrt-biote brand is what I'm on and love. It has increased my bone density
You go girl! I’m 71 and still on hrt.
I agree with the mental clarity comment! I had a total hysterectomy including ovary removal and HRT has given me such clarity of mind. My life is 100% better because of mental clarity. I’m 46.
I am a NAMS NCMP & saw Dr Mason speak at ASRM 2022. She continues to say we will never have a chance at another HRT RTC, but refuses to use any of the high quality ocservational data we DO have on E2+OMP. Please bring Drs Buming & Tavris back for an update!
I’m tired of hearing her say “we don’t know”!! I’m 61 and I’ve been struggling with menopause for years…….
I was on Estradiol with my previous pcp BUT the last couple years my FNCP or whatever her acronym is took me off of it because my Mom had breast cancer in 2020.
Thank God she’s completely cancer free🙏🙏🙏🙏
But I feel personally I should be given the opportunity to get back on the Estradiol considering I AM THE ONE STRUGGLING!!
Manson is infuriating. Her arguments that women shouldn't be on HT to protect us from debilitating fractures because of the PURPORTED long-term risk of breast cancer is such a false equivalency and does a disservice to millions of women. She has set us all back because she is so convinced of her opinion that women in their fifties seldom have fractures. 58:20 What about joint instabilities and massive pain that prevent us from performing bone-strengthening exercises that PREVENT THE FRACTURES IN THE FIRST PLACE?? We need the estrogen for that!!
I was lifting weights successfully for years and getting stronger on ET. I couldn't see my provider for 5 weeks, and my knees developed severe pain. I couldn't even walk. FIVE WEEKS. that was all it took to deplete my estrogen
To be honest the night sweats were crushing for me and my obgyn told me to simply deal with it. The lack of sleep has been crushing. The denial of therapy despite years long suffering is a disaster for women.
Oh Dr.Attia so happy that you take stance that you do on hormone replacement therapy. I’ve been very lucky never had a hot flash I’m 77.5 actually 77.6 and I took it early on Waltz through it. I did not change life to very late in the 50s And I believe it’s good but I believe they were all some of us are scared of the word cancer, so this is a good show for me. No wt problem ever love exercise and played tennis since I could hold a racquet. Diet only eat small amount of grass fed organic beef or chicken; much sea food; don’t drink at all; low glycemic carbs; no soda 40 or 50 years. Understand sugar but wow love Costco’s desserts: But try to use it as a sacrament upon occasion only. My age grew up on Whole Foods. Sorry so long but I’ve walked a tight line. No smokes. Take NMN,NO, K2 D3, Krill oil. Have all my body parts
Thank you so much for this interview! I am now 56 years old. Menopause at 46. Bruh! Them hot flashes ain’t no joke! Also osteoarthritis! Have changed my diet! Weight training! And my Doc has tried 3 times to talk me into stopping my hrt! I did try twice, hot flashes were brutal! She 1:14:02 has since stopped thank goodness. And I have no desire to ever stop. Otherwise, I’m perfectly healthy, do all my yearly screenings. And I really would
Like for someone to help me with this arthritis! I don’t want to die of a hip fracture like my great grandmother!
The old studies they now look at, it was synthetic progesterone that increased the risk of breast cancer not estradiol
I’m 32 years old and started reading part I of your book some hours ago and right off the bat, thank you for putting it out there. Against my doctor’s wishes, I had a basic check of my vitals because I felt something was wrong with my chest. Blood work came back saying I’m pre-diabetic. Can’t wait to learn more about this in your book and how to structure my diet and exercise to fight this.
go low carb + 1g per lbs of bodyweight per day in 3/4 meals, resistance training 3x a week, cardio 4x time 45' per week, and your pre diabetes will magically disappear.
Get Satchin Panda's book: The Circadian Code: Diabetes, you can put your condition into remission + get a few extra years of life for free by applying newer healthy habits.
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I have been forwarding your last conversation to my friends, nurse co workers and family members at my work assignments who express interest. Thank you for those discussions and providing this information. I decided to get hrt and am very happy with my decision. I see a lot of older women patients with bone fractures and dementia. I often wonder if they had more complete information if they might have made different choices and perhaps maintained better bone, heart and brain health.
Honestly hot flashes and sweats are the least of my concerns. What about mental functuons, brain fog, memory loss, etc. And what can we do to avoid that bone denisty loss? I never wantbto stop HRT if my bone density will drop.
I love these mega experienced drs speaking about their work. You should interview Professor Susan Davis on her work on testosterone for women.
Thanks Dr Attia for at least bringing up this issue, we never hear about. I have listened to several podcasts and also read sbout the failings of the Women's Health Initiative. Based on my own research, I feel this guest was a bit biased to the WHI considering she analyzed the data. Specifically there is a huge problem with the health of the sample. Most women in their 60's with significant health problems such as high blood pressure, smokers etc. How does this translate in any shape or form to healthy perimenopausal/menopausal women in their late 40's/early 50's with menopausal symptoms, considering most of the women had gone through menopause or had no symptoms?? I wish this podcast had gone more in depth in the protective benefits of estrogen against cognitive decline and bone health. The same number of women die of hip fracture as those who die of breast cancer. An excellent book, "Estrogen Matters", by Dr Avrum Bluming and Dr Carol Tavris highlights some of these research findings. Dr Barbara Taylor is another excellent source, here on You tube. Both that book and her findings have saved my life, with bio identical estradiol and progesterone for sleep and hot flashes. Please consider interviewing these clinicians in upcoming podcasts for women's health.
Well said. Every woman and health care provider should read “Estrogen Matters”
Dr Mary Claire on RUclips is an expert.
I started total menopause with 40yrs. my symptoms were very strong and interrupting my live. At that time there were only the horse
urine and synthetic
hormones available which I refused to take, changed a lot around my diet to relieve symptoms, helped a bit also lots of supplement and Acupuncture but it was very limited
in relieving symptoms. after 5 or 6 years bio identical hormones were available. I was not very functional in life without it. I was soooo happy .Live became livable again. I exercise very regular[ Daily] and eat a very healthy diet have all the regular test done and increased my spine density 3years ago
by 8%.I am 76years old still work parttime, do all my yard work and Gutter cleaning. I had no choice not to take it and have done with it very well.
When did you start HRT?
@@amylee9 I started at 45/46 yr
How do you do a yard work and Gutter cleaning? Please share
I was suffering with symptoms for AT LEAST 6 to 8 years prior to being diagnosed with endometrial cancer last year. I went to my yearly gyn exams and dr. would say, everything good, see you next year - year after year. Despite the fact I sat there and complained every year to him, I was not feeling well. My doctor never not one time offered me hormones after listening to how miserable I felt. It infuriates me to this day.
so sorry to hear this - what do you think should have been done? And what were your symptoms?
@@Mychellechic I went to year gyn appointments for your typical exam. I would sit there and complain year after year with symptoms and the GYN never once offered me bio-identical hormones.
Rinse. Repeat.
For 99% of women everywhere!
Apparently some drs have a code name for us "WW" - whining woman! So infuriating! 😡 I, too, have had my life severely impacted by menopause and 'scared' to get HRT because of a family history of breast cancer. I'm heading to my Dr as soon as possible and demanding treatment. I'm so angry.
I’m in post menopause. I now have osteoporosis and want hormones to help. I would sign up for a trial on this.
I would appreciate a deeper dive on what a woman that has had breast cancer should do to treat the long term effects of menopause.
ruclips.net/video/iqC9_lBafxs/видео.html
I also recommend the book “Estrogen Matters” by oncologist Avrum Bluming, MD and Carol Tavris, PhD
I have had doctors trained in S. Africa and Australia. I have been on compounded HRT Bi-est and natural progesterone for 25 years. I'm now 64 ears old. I check in with my doctor every month. I have never gone through menopause. I have have younger looking skin to those compared to others my age w/o HRT. My energy is high, I have less depression and emotional lability. I work out daily, have a positive attitude and my body is still muscular and no weight gain. I was told by my women's health specialist I can stay on it well into my 70. i had a hp replacement 2.8 years ago. I have recovered with minimal medication. I have improved my strength and stamina is amazing my surgeon and phystiotheapist.
You wrote that you have not gone through menopause.. Do you mean you still have your period in your age???
If you have not had your period for 1 full year, you have gone through menopause at your age.
@@nedrawilliams6657I think she means she completely bi-passed symptoms due to HRT and lifestyle.
I was afraid of HRT because of breast cancer risk and have changed my mind after listening to another one of your episodes and getting to know I wouldn't need progesterone, since I don't have an uterus. It has changed my life. I had been suffering from menopause symptoms for years. My sleep was ruined, my insulin sensitivity was ruined. Thank you for informing us!🌻
Even though doctors routinely says progesterone is unnecessary without a uterus . . . it's a major factor in menopause insomnia.
Hrt can contribute to breast cancer, i had no genetic or family history and developed breast cancer on bio identical hormones. After mastectomy i asked if it was ok to go back on hormones and it was a firm no from whole cancer team. Messages that it’s harmless is dangerous because we all react differently and the truth is it’s a risk you need to be aware of when you make your decision to take it.
@@kp-gh7nn i had triple negative breast cancer, but Moffitt Cancer Center and MD Anderson still say I cannot go back on HRT and I was on bio identical hormones and oncology says no way.
I really appreciate that Dr Joanne Manson gave this interview and you were able to go into depth to understand what the heck was going on with this study. I don't understand why the cost of running another 8 or even 30 year study on HRT couldn't be justified. And I don't think you can say that you can't justify it because the HRT medication in the study will have become obsolete after 8 years. Surely scientists know how to structure a study that accounts for this. We are 50% of the population and we have a right to have better knowledge about the benefits and risks of HRT long term. As a woman approaching menopause I need accurate answers on HRT risks.... A lot of us will be going ahead with HRT long term because frankly there are too many negatives without it. So we are leaving being left in the dark on this. For me personally I would like to take HRT while doing heavy strength training to maintain my bone density. I'm currently recovering from a fractured foot and I do not want to be negotiating fractures as I get older.
THIS exactly. When she mentioned it would be too expensive to do another study, she told me that she believes that women's health isn't important enough or worth spending money on!!! I was shocked to learn that a significant amount of medical research has only been conducted on men and that women are thirty percent more likely to die from medical mistakes than men. Women definitely need more medical research!
What about testosterone levels dropping in woman?? Why is this hardly discussed. Muscle mass, fitness, brain health, mental health, sex drive...
Thankfully the functional medicine drs I've seen have emphasized that B-HRT benefits go beyond just relieving menopausal symptoms.
I totally agree! The right levels of estradiol and progesterone are protective against several long-term health issues, especially osteoporosis.
Why are hot flashes the focus!?!? Such a narrow view.
So many women suffering from insomnia. How do we improve that?
Thank you! This podcast was wonderful. Yes, I am one from that generation of women fearing hormone replacement causing cancer. Now I’m on BHRT. Thanks again
How’s it going for you?
@@NMW80 it’s going fine, but I never had adverse symptoms anyway. Doing it for anti aging purposes, seems fine, and my lab values are good
Peter, I’m glad you interviewed her. It’s more than obvious that she’s still of the mind set of the ‘old ways’, whereas YOU, are more progressive in your thinking and I’m guessing, treating of people. I wish there had been more emphasis placed on the fact that this entire debacle of the WHI was ALL synthetic hormones……not bio-identical. That fact in itself is still confusing to people. And I’m glad you kept pushing and emphasizing the benefits of HRT.
The situation has led to a degree of perplexity. I believed my understanding of BHRT was firm, yet I wonder if the matter pertains to the differentiation between Progestin and the utilization of Progesterone. At present, I am undergoing oral progesterone treatment to address menorrhagia during peri-menopause, given my age of 48 years. I agree, we most definitely need another study with current BHRT’s. I greatly appreciate your sharing such enlightening videos. I have been dedicatedly studying the intricacies of menopause for the past few years, diligently preparing for its eventual onset.
I've read through the comments and I see the frustration with her repeatedly saying that FDA approved HRT is probably OK after careful consideration of all the risk factors for hot flashes and associated menopausal symptoms. She is clearly staying in the FDA approved lane and understandably not recommending a medication for an Off label use. I understand everyone's frustration and I think she could have just stated for the record that she was not going to recommend an approved medication for anything other than what the FDA stated. She is a high profile researcher and clinician, probably on the pay role of a few pharmaceutical companies. She has no other choice. There are very serious consequences for recommending mediations for off label use. This actually might be an interesting topic unto itself.
Why isnt the estrogen window discussed. ? She keeps talking about night flashes but what about osteoporosis, Alzheimer’s and heart disease? Is this really not fully established?
It would be great to counterbalance this talk with an interview with someone like Dr. Felice Gersh.
This was very informative, thank you! Any chance Dr. JoAnn Manson would come back and talk about thyroid health? As an endocrinologist she would be a wealth of information. Thank you again for this podcast.
NO Questions ****women need NOT BE DENIED estrogen!!!! Not educating women on estrogen therapy is a terrible blow to women and it’s insulting that clinics are handing it out to children instead of post menopausal women!!!!
Dr Attia, thank you so much for caring enough about this topic to explore the facts and the truth for women approaching menopause.
Women need to have open resources to cope with Post Menopause. They need Hrt therapy resource centers, and until we are in a place were women are able to get hormones and education that needs to come first. It makes me sick how there is so much info for children on hrt . When there is zero for women. The medical system is failing women!!!
Great idea to interview one of the investigators with the WHI, and great interview, thank you!
One thing that I haven't heard discussed on this topic is the impact of birth control for many years. I was on BCPs from the age of 15 to 35 when I was told I had to be taken off it because of the increased risk of blood clots. I never had any issues being on the pill but I have had endless issues since. I had a tubal at 35 as well and I don't know if it was the tubal or going off the pill that caused my issues but I ended up with extreme bleeding after that that doctors shrugged off for a decade. Eventually I found a doctor to do an ablation to stop the bleeding and that was great for a few years until what I assume is menopause started. It's been so awful with hot flashes, night sweats, mood swings, brain fog, dry skin and more I'm sure. I'm thinking there is a connection here to controlled hormones for so long and then none set my body into a tailspin. I wonder if it's too late for HRT? Will it help me after all this at 58?
Another thing you should talk about is how we found out in the 80's or 90's some time that for decades they never even did research on women, they just assumed we were just like men.
My gp wants me off hrt due to risk of breast cancer reoccurrence..im 67 and i dont want to come off it ...i had a grade 1 tubular carcinoma breast cancer seemingly with low reoccurrence rates ..whats your thoughts please please?
Thank you Dr. Attia for having this important topic of HRT. This discussion helped validate my recent one month use of Estrodial patch .025mg with Progesterone. Overall, it's helped me feel better mood and happier. Hasn't quite helped with hot flash but i might have to kncrease dose. Very helpful discussion. Also the osteoporosis aspect is an eye opener. Thank you.
Why do I have a hard time to believe what she is saying…….🤔
Peter should run a trial
1)Had TIA from birth control 2 decades ago. 2) lumpectomy-benign during teen years 3) stage 4 endometriosis 5) maternal breast cancer 6) surgical menopause since 2020 from emergency surgery for removal of cyst, w/o any HRT-was not advised 7) now cholesterol is high 8) LDL high 9) A1C 5.9 all time high 10) belly fat increase 11) muscle mass reduction 12) herberdens nodes forming. .13) can no longer run 14) Took me three years (after orilissa treament in 2020 after hysterectomy to treat endo) before i could finally do 3 sets of bicep curls with an 8lb weight..i feel like ive been put on a fast track to my grave. All the info has many overlaps and one contraindication can cancel another issue and vice versa. Can someone, anyone, please help me navigate, I'm so freaked out and confused but i want to live to see another day , I have a family, I am 53. It's like being the subject of mean joke and only getting worse.
By the way sleep problems are a major, not minor health issue
This frustrates me so much. I am just short of 68 and have been on BHRT since 51. I have ZERO history of breast cancer. My bone health is awesome for my age. I don’t want to stop taking hormone replacement ever! And yet, doctors here in Portugal won’t prescribe it. I don’t want my bone health to decline. I don’t want my cholesterol to go up - it has always been in a very healthy ratio. And I am willing to live with these slight risks she spoke of.
I fast several times a week, (sometimes 36 hours,) walk and exercise.
I try to taper off Progesterone and I can’t sleep!
I’m having vaginal atrophy with pain and burning. How will this get any better with no hormones?!
In the states doctors can prescribe to anyone. It can even be done on line. Bioidentical hormones should be within your reach that way. You might need to have someone ship the hormones to you.
"Just take an anti depressant" 🤦♂
When she said that she lost all credibility
Excellent podcast, thank you Peter and JoAnn! Highly recommended listening for every woman 50+.
Everything is risk versus benefit in life and I feel the benefits of HRT far outweigh the risks. We replace insulin, we replace thyroid, we replace hydrochloride acid, we replace digestive enzymes, why would we accept the loss of hormones? At first that’s what the doctors said, this is normal for menopause. Well it wasn’t MY normal. People owe it to themselves to try anything that is reasonable to maintain their all over health
The Pharma industry wants women to get the three diseases of menopause, heart issues, bone loss, and dementia, so they can peddle their expensive drugs instead of the CHEAPER HRT. Follow the money.
Can we look at data from last 20 yrs of women that were not prescribed hrt because of previous study??
As always THANK YOU for bringing such extraordinary guests.
Thought this was all great info until she mentioned being prescribed anti depressants for menopause symptoms Shame on you Dr Manson
Couldn’t agree more
There are so many reasons why the study participants could have gotten breast cancer and heart attacks etc. Statin increase from 7% to over 50% during the study, their sugar and carbohydrate consumption which could feed any cancer cells, etc. So many variables. It’s a disgrace really that we women have to go through this drama and anxiety about what we can do and what we should be doing and have to fight for our HRT scripts like we are doing something negative to our health, while the medical profession is happy to give out statin scripts Willy Nilly etc. Peter is an amazing Doctor and I loved his comments particularly his summary at the end of this interview.
Also, take a look at what happens when you take oral estrogens as opposed to transdermal estradiol. Estradiol actually lowers risk of breast cancer and is highly anti-inflammatory.
I remember reading a 25 year study of nurses nationwide in the 90s (quickly scrubbed from the internet), which showed women, like myself, who had hysterectomies in their 30s and 40s, before menopause, who waited until the onset of symptoms (sweats, hot flashes) which were typically two years post surgery, and who then went on bioidentical estrogen replacement. That group, the only one, had zero incidence of breast cysts or masses of any kind, and zero cases of breast cancer. I've been on a quite high dose (claims every doc, even though I use the minimum dose that relieves symptoms) for 40 years. I only allow breast ultrasounds (don't want cancer from mammograms), which confirm the continuous healthy condition of my breasts. My last doc just died, so on to find my next, and hopefully, last medical opponent to my being "allowed" to live symptom free. My body my choice.
So you mean no one in that group got cancer etc?
@@NMW80 yes. No one got breast cancer, any lumps or any cysts. As myself, after 38 years on bio identical estrogen, I've never had any issues at all.
Millenium You do know that everybody is different from the others, except for identical twins...
I feel this episode was wasted and as a regular listener I feel the same thing was said over and over. There was one very interesting point that Peter was trying to make about hip fracture incidence reduction. It sounded like he was saying that the study was only powered to detect incidence in hip fracture and not mortality, but if we were to extrapolate based on general hip fractures there would be a huge mortality benefit from decreasing hip fracture incidence, and this reduction would presumably still be a large net benefit over any smaller risks from HRT. The guest completely avoided engaging in this type of intellectual discussion though, it was so frustrating. I also feel this episode should have talked more about HRT and why so many people are interested in taking it. There is a belief in the general public that HRT can partially restore a youthful mood, energy, and sexual function. And more generally, people think that because sex hormones decline with age, HRT feels like a smart general wellness option. Peter should be addressing these ideas, even if it is just to say which parts are naive or not evidence-based. The ideas are too big in the public's mind to ignore.
In the study, 16,000 women took estrogen plus progestin and 385 of them were diagnosed with "invasive" breast cancer. How many diagnosed with "non-invasive"?
Please get Dr Louise Newson on a podcast . She seems to know alot more updated and relevant information on HRT and the many symptoms than this woman ! Menopause does not just cause sleep problems , hot flashes and night sweats 🤔😞
Also Dr. Mary Clare Haver.
My mother participated in the Women’s Health Initiative in 1995 at University of Alabama in Birmingham (UAB). She was an extremely healthy 65 year old when she started the study. 7 months later she was diagnosed with a 6-7 cm tumor the size of a small grapefruit that originated in the ovaries. She died 3 yrs later. My mom was not in the placebo group and she was immediately dismissed from the study. All this made me very weary of HRT but after much coaxing from my OB/GYN I decided to take bioidentical HRT. I do get vaginal ultrasounds every year just to make sure there are no visible tumors. My Dr. assures me it was from the “estrogen dumping” that was done in the study.
Still miss my mom and wonder if she might have lived 20+ years or more without the Women’s Health Initiative.
I have been on bio-identical hormone replacement foe 21 years. Suzann Somers started the information on why it is so important!
Too expensive!
The comments in here are golden / invaluable to every women out there ! But also for practitioners / scientists in facilitating resolution to those suffering/really suffering… Docs need to give us all choices ! Like another lass said it’s our body /our life) …. And someone mentioned dementia in here which I’m not sure was touched on much in this discussion - but is huge ! The menopause and it’s detrimental effects on the brain. Lisa Mosconi (neuroscientist) has done so much work on this topic and claims the significance of taking HRT to stave off dementia is huge. But ultimately it’s down to quality of life in the time we have and as many women on here have said the symptoms of menopause can be horrific !! For me sleep deprivation ruins your quality of life /ability to function mentally & physically- everyday is a struggle, but HRT alleviates on so many levels. We of course are all different and we all need different solutions but we ALL need the choice . Xx
Peter Attia's point that the hormone replacement estrogen what progesteron estrogen therapy continue to the seventies can reduce incidence of hip fractures is important. I would also like to know what kind of therapies if any can be use to reduce male hip fractures in their 70s and 80s.
After a radical hysterectomy, I had HRT, first by pills, then patches and then creams, for estrogen and progesterone. They all made me ill. Got off all of it, and I gradually felt better.
It’s important to address the underlying chaos in the body. Liver health etc
You were GIVEN POSION ..ON PURPOSE.PHARMACEUTICAL CRIMINALS not given BIOIDENTICAL HORMONES REPLACEMENT THERAPY..NOT COVERING BY ANY INSURANCE. I WAS SAME POSITION ONCE I SWITCHED TO BIHRT IT CHANGE MY LIFE BACK TO NORMAL
Some women don’t tolerate the progesterone component of HRT and don’t feel well at all on it. I wonder why you were prescribed progesterone, since it’s only a requirement for women who still have their uterus. Perhaps it’s possible, the progesterone was the “problem” in your case.
@@cm1906 I was prescribed estrogen first, couldn't tolerate it, then taken off estrogen and put on progesterone, where I couldn't tolerate as well. This happened 3 decades ago, so (I hope) medical science has advanced since then.
There is limited research on the risks of strokes, dementia, and heart disease associated with estrogen patches with a progesterone-coated IUD. However, two studies did not find an increased risk of these diseases in women who used this combination therapy.
1."Estrogen patch and progestin-releasing intrauterine system for postmenopausal women with non-estrogen receptor breast cancer: a randomized clinical trial" (2022) by Moyer et al., published in the journal Cancer. This study was a randomized controlled trial, which is the gold standard for medical research.
2. "Estrogen patch and progestin-releasing intrauterine system for postmenopausal women with non-estrogen receptor endometrial cancer: a randomized clinical trial" (2023) by Neven et al., published in the journal Obstetrics & Gynecology. This study was also a randomized controlled trial.
Both studies found that women who used estrogen patches with a progesterone-coated IUD did not have an increased risk of stroke, dementia, or heart disease.
Bravo and thank you for addressing HRT. I had a complete and elective hysterectomy in my early 40's. I was placed on estrogen and ultimately testosterone. Prior to and after treatment I would participate in endurance sports (Ironman, swimming). At one point and new internist took me off testosterone. I went from running the Chicago marathon to not being able to run a mile (and taking several days to recover). I begged the doctor to put me back on. No body would and I reached the point of telling the doctor that I was a transgender male. I knew that endless amounts of testosterone would be given. I did not do this as I wanted a relationship with a doctor. Anyhow, I thought that i was going crazy. I went to a psychiatrist. He referred me to an oby/gyn and without I fnishing my sentence, she understood my problem and placed me back on testosterone (estro-test). My prior engergy never fully returned however, now I can run a 5k (before i over heat). I continue swimming(masters). I still struggle with mild fatigue and a decrease in motivation. I was off testosterone for two years and the experience was horrible.
It was irresponsible of the doctor to take you off testosterone in the first place! You present dosage is too low from the sounds of it. It irritates me that being prescribed hormones is very difficult for most of us yet doctors will willingly prescribe massive doses to people far too young for any form of hormone treatment if they say they are transgender, ruining their health and hormonal profile for life! Hypocrites is a good name for these Doctors.
I’ve ended up at a transgender clinic where I can get my testosterone prescribed along with my estradiol and Progesterone.
@@maudiefricker You probably need just testosterone as your body will make estradiol from it. Progesterone will oppose estradiol if it rises too high.
Unbelievable! I can’t believe it was a WOMAN who did this! We needed HRT and she let this happen. All she does is justify her failure of a study.
I read somewhere that there was nearly a billion dollars spent on this study. One billion $$$$. That can only mean the scary "you will get cancer!!!!" outcome was worth a great deal more to them.It was the outcome they wanted. While HRT is valuable to women's health and QOL. But not providing HRT is way more valuable to the medical industry.
Exactly! She's a disgrace to woman-kind.
I’m 65 never taken or considered HRT, listening by chance tonight.. I’m just left confused… sounds like I’m in higher risk age group, I’m experiencing pain & brain fog..
How about doing a discussion about "Older" women 70's & beyond, using hormones. I just read the book by Becca Levy " Breaking the age code" Now I see Ageism everywhere! Getting older will effect EVERYONE (if you're Lucky! ) I wish everyone would read this book (Especially Doctors) It's a real eye opener!
1:06 15X reduction in mortality age 50 to 80 on HRT
There are some studies on women is elder care facilities.
Was iron loading considered a confounder in the difference in the onset of heart disease between men and women and could that also be the increase of all cause mortality in post menopausal women. The oxidative stress caused by the increased iron levels has to have a significant negative effect on health once a woman's period ends.
Wow this was amazing!! Thank you so much for sharing this incredibly informative interview..🙏🏼
Still I find that most interviews don’t really touch in the intravaginal HRT, I will look for that in your channel, hope to find it 🤞🏼🤞🏼
She reports that risk outweigh benefits as we get in our 60s-80s but was this really studied? Its true for women who are started on hormones that late but do we really know that the prolonged use increases risk?
I know there is research suggesting starting within 10yrs of menopause showed benifit..but after 10 yrs increased risk. Sorry i dont recall source. But research it.
Please interview another practitioner with expertise in this area with no need to defend the WHI due to personal involvement in the study.
YES!!! Agreed. And what the heck I have like 5 more symptoms and haven't had night sweats or hot flashes at all!!! How about anxiety, depression, joint pain, paranoia and belly fat! The other symptoms weren't even mentioned. 😢😢
Exactly! She's definitely not an unbiased speaker.
Exactly it was so weird hearing them just refer to the less concerning symptoms of menopause
Excellent podcast. I’m one year into perimenopause and have been very thankful for HRT!!!
Dr. Manson is a gifted communicator. Thank you for this.
It's so irritating to hear her go on about hot flushes and night sweats as if they're the only troubling symptoms. So many women have taken their own lives because they found menopause so hard and ended up with depression and anxiety. For me, I had terrible heart palpitations and crippling anxiety when I started perimenopause and taking HRT has been life changing. The depression, brain fog, increased heart disease risk, lower bone density risk etc etc surely outweighs the extra one case in a thousand of breast cancer, which may not even affect mortality!
38 and in surgical menopause due to cancer and I swear the joint pain, fatigue, and brain fog have given me those thoughts. Especially the joint pain. I honestly can’t live with it. Thankfully HRT has eased it off but before that it was literal hell.
Absolutely! Menopause is not just about hot flashes. Depression and anxiety are serious, life-threatening symptoms for many women. Women who have had a hysterectomy and "don't need progesterone" are often the ones suffering from anxiety, depression, and insomnia, even if they do get estrogen.
I agree
Is there any evidence or data available on how long one should be on HRT? Do the risks of breast cancer and/or uterine cancer increase the longer one takes HRT? I've been on it since 47 and i'm 54 now and i wonder how long to continue taking it. I feel good on it with some slight spotting here and there, with no health history of any cancer at all. Can I take it forever or is there a stopping point?
You shout be able to take it indefinitely. You need your hormones. Estradiol has rather showed to help against breast cancer ruclips.net/video/klLKxLSzF8s/видео.html
If you listen to the podcast you can find an answer: risk is very low in early menopause but increases with age. So there’s some stopping point, maybe 60 or something.
There is a small increase in breast cancer. But heart disease kills way more women than breast cancer and hrt helps alot. Take hrt, eliminate metabolic syndrome causes and hrt will improve your life . There is no coincidence there is no dementia and very little breast cancer and osteoporosis in premenopausal women. If you eliminate smoking and metabolic syndrome, you virtually eliminate these conditions.
So many conflicting opinions on this…
i have watched the entire podcast and she does say that we can "assume" the risks go up as we age, but why is that? Doesn't the risk of everything go up as we age? Like Peter said, the risk of dying from a hip fracture after 65 is a lot higher than the risk of getting breast cancer. I guess there really isn't any reliable data from studies on HEALTHY women who have been taking ONLY bio identical hormones after 60??? I am 5"6", 125, and have been working out hard for over 35 years! i eat very clean and rarely drink. I am not the average woman. I guess i would like to see some real data on women who have been on HRT (bio identical), have no history of cancer or heart disease, eat well and exercise (strength train, cycle, hike, yoga) and see how HRT affects them AFTER 60. I just wonder if I have to stop taking HRT at 60 or i can keep taking it as long as I'm getting screenings regularly.
Increased risk of stroke with hormones that we no longer use
So is the takeaway that if there is breast cancer in your family (mother) and in your late 40s / early 50s and in menopause, that the risk ratio is higher than the 1:1000 quoted here (if women weren’t excluded from the trial with this situation) and therefore STILL not recommended to go in HRT even if they are suffering terribly with hot flashes and night sweats it’s effecting their/their partners sleep and wellbeing?
That’s the reason we were listening?
What if I’ve been taking BHRT since 2003 or and learned I had endometrial carcinoma-E+ and P+ type.. Then a total hysterectomy which cleared the existing cancer that had not metastasized. Now, as I don’t need opposing progesterone, the doctors say no more estradiol patches either. I have managed osteopenia and hypothyroidism, mitigated with and Vitamin D3 and levothyroxine Ii miss the benefits the estrogen patches provided. Now what? Am I doomed to increased frailty and brain fog and increased cardiovascular concern? Plus my sleep is very disrupted and I do get some vasomotor symptoms I didn’t have before, among other things. Is there any clinician reading this that thinks it’s ok to restart with an estrogen patch after having had endometrial cancer? I just had the surgery in mid-July and it’s nearly October. As I said, there is no evidence of remaining cancer. I’ve never had breast cancer or anything else. I am just shy of 70. Please provide some thoughts if you are an MD or DO, particularly in gynecology. Thank you.
Best Doctor in the world ! Excellent !
I am interested in a podcast where Dr Manson discusses her knowledge and research about vitamin D. Vitamin D therapy is so important.
This doctor is 70 years old. She might be on HRT herself to have such mental clarity. 😊
I have a recent history of very low grade, very small breast cancer. I can’t find a doctor that will let me chose an increased risk of the return of breast cancer in order to prevent the very risk in my family of Alzheimer’s and heart diseases. Instead my golden years will be spent not sleeping, not getting off my couch, suffering from anxiety attacks, hot flashes and memory issues. My family will have to take care of my Alzheimer’s like I didn’t for my mother who passed 7 months before my breast lump. My mother’s mother also died at age 60 from early onset Alzheimer’s. There is no cure.
For Alzheimer's treatment look up Dr. Dale Bredesen protocol
I also thought it was interesting when they stop the trail because of heart issues. She just blew it off and focus supposedly all the good things that took place. It sounds like she was just saving face.